Evaluating the effect of gestational diabetes mellitus on macrosomia based on the characteristics of oral glucose tolerance test

Wenlin Bai; Hui Wang; Ruiling Fang; Mengwen Lin; Yao Qin; Hongjuan Han; Jing Cui; Rong Zhang; Yifei Ma; Durong Chen; Wenping Zhang; Li Wang; Hongmei Yu

doi:10.1016/j.cca.2023.117362

Evaluating the effect of gestational diabetes mellitus on macrosomia based on the characteristics of oral glucose tolerance test

Clin Chim Acta. 2023 Apr 1:544:117362. doi: 10.1016/j.cca.2023.117362. Epub 2023 Apr 22.

Authors

Wenlin Bai¹, Hui Wang², Ruiling Fang¹, Mengwen Lin¹, Yao Qin¹, Hongjuan Han¹, Jing Cui¹, Rong Zhang¹, Yifei Ma¹, Durong Chen¹, Wenping Zhang¹, Li Wang¹, Hongmei Yu³

Affiliations

¹ School of Public Health, Shanxi Medical University, Taiyuan 030001, China.
² Obstetrics Clinic, Changzhi Maternal and Child Health Care Hospital, Changzhi 046000, China.
³ School of Public Health, Shanxi Medical University, Taiyuan 030001, China. Electronic address: yu@sxmu.edu.cn.

PMID: 37088117
DOI: 10.1016/j.cca.2023.117362

Abstract

Background: GDM is always treated as a homogenous disease ignoring the different metabolic characteristics in oral glucose tolerance test (OGTT). We assessed the effect of GDM on macrosomia based on the different characteristics of OGTT.

Methods: We retrospectively divided 998 GDM pregnant women into 7 groups, Group A1: abnormal OGTT_0h; Group A2: abnormal OGTT_1h; Group A3: abnormal OGTT_2h; Group B1: abnormal OGTT_0h+1h; Group B2: abnormal OGTT_0h+2h; Group B3: abnormal OGTT_1h+2h; Group C: abnormal OGTT_0h+1h+2h.

Results: The incidence of macrosomia in group C (21.92%) was higher than other groups. The OR of OGTT_0h+1h+2h was significant (OGTT_1h: OR = 1.577, 95% CI: 0.791, 3.145; OGTT_2h: OR = 1.151, 95% CI: 0.572, 2.313; OGTT_0h+1h: OR = 1.346, 95% CI: 0.584, 3.101; OGTT_0h+2h: OR = 1.327, 95% CI: 0.517, 3.409; OGTT_1h+2h: OR = 0.771, 95% CI: 0.256, 2.322; OGTT_0h+1h+2h: OR = 4.164, 95% CI: 2.095, 8.278) when comparing with OGTT_0h. Subgroup analysis showed abnormal OGTT_0h+1h+2h might contribute more to macrosomia in pre-pregnancy BMI ≥ 24 kg/m² than those with BMI < 24 kg/m².

Conclusion: The effect of abnormal OGTT_0h+1h+2h on macrosomia was significantly greater than other OGTT characteristics, especially for those with pre-pregnancy BMI ≥ 24 kg/m². Individualized management of GDM based on OGTT characteristics and pre-pregnancy BMI might be needed.

Keywords: Body Mass Index; Gestational diabetes mellitus; Gestational weight gain; Macrosomia; Oral glucose tolerance test.

MeSH terms

Adolescent
Adult
Blood Glucose / analysis
Blood Glucose / metabolism
Diabetes, Gestational* / metabolism
Female
Fetal Macrosomia* / diagnosis
Fetal Macrosomia* / etiology
Glucose Tolerance Test
Humans
Pregnancy
Retrospective Studies
Young Adult

Substances

Blood Glucose